Brown Theresa, Nauman Vogel Emily, Adler Sarah, Bohon Cara, Bullock Kim, Nameth Katherine, Riva Giuseppe, Safer Debra L, Runfola Cristin D
PGSP-Stanford PsyD Consortium, Palo Alto, CA, United States.
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States.
J Med Internet Res. 2020 Apr 23;22(4):e16386. doi: 10.2196/16386.
Novel treatment options for eating disorders (EDs) are critically needed to enhance treatment outcomes and reduce the rates of treatment dropouts. On average, only 50% of individuals receiving evidence-based care remit, whereas 24% drop out before treatment completion. One particularly promising direction involves integrating virtual reality (VR) with existing evidence-based treatments (EBTs) such as cue exposure therapy (CET). Across psychiatric disorders, VR-based interventions are demonstrating at least preliminary efficacy and noninferiority to traditional treatments. Furthermore, VR technology has become increasingly portable, resulting in improved acceptance, increased access, and reductions in cost. However, more efficient research processes may be needed to uncover the potential benefits of these rapid technological advances. This viewpoint paper reviews existing empirical support for integrating VR with EBTs (with a focus on its use with EDs) and proposes key next steps to more rapidly bring this innovative technology-based intervention into real-world clinic settings, as warranted. VR-CET for EDs is used to illustrate a suggested process for developing such treatment enhancements. We recommend following a deployment-focused model of intervention development and testing to enable rapid implementation of robust, practice-ready treatments. In addition, our review highlights the need for a comprehensive clinical protocol that supports clinicians and researchers in the implementation and testing of VR-CET and identifies key missing protocol components with rationale for their inclusion. Ultimately, this work may lead to a more complete understanding of the full potential of the applications and integrations of VR into mental health care globally.
迫切需要新的饮食失调（ED）治疗方案，以提高治疗效果并降低治疗中断率。平均而言，接受循证护理的个体中只有50%康复，而24%在治疗完成前退出。一个特别有前景的方向是将虚拟现实（VR）与现有的循证治疗（EBT）相结合，如线索暴露疗法（CET）。在各类精神疾病中，基于VR的干预措施已显示出至少初步的疗效，且不逊色于传统治疗。此外，VR技术越来越便于携带，从而提高了接受度、增加了可及性并降低了成本。然而，可能需要更高效的研究流程来发掘这些快速技术进步的潜在益处。本文献综述回顾了将VR与EBT相结合（重点关注其在ED中的应用）的现有实证支持，并提出了关键的后续步骤，以便在必要时更快地将这种基于创新技术的干预措施引入实际临床环境。用于ED的VR-CET被用来说明开发此类治疗增强措施的建议流程。我们建议遵循以部署为重点的干预开发和测试模型，以实现强大且可用于临床实践的治疗方法的快速实施。此外，我们的综述强调需要一个全面的临床方案，以支持临床医生和研究人员实施和测试VR-CET，并确定关键的缺失方案组成部分及其纳入的理由。最终，这项工作可能会使人们更全面地了解VR在全球精神卫生保健中的应用和整合的全部潜力。
